Abstract:

This study summarized the nursing experience of midline catheter insertion in 12 patients with a body mass index ≥50，providing clinical references. Key nursing interventions included：pre-insertion patient positioning was adjusted to semi-Fowler's or sitting position based on respiratory status. The puncture sites were chosen at the middle or distal third of the upper arm with elbow flexion. The widened tourniquets and extended-length needles/catheter sheaths were used according to vascular depth and puncture angle. The modified pre-insertion length measurement and real-time ultrasound-guided vascular puncture were applied. The catheter with crisscross elastic bandage was secured post-insertion. All 12 patients successfully underwent catheterization，with devices removed after completing intravenous therapy and blood sampling.

Key words: Extremely Severe Obesity, Midline Catheters, Vascular Access Devices, Nursing Care

摘要：

总结12例体重指数≥50的极重度肥胖症患者中等长度静脉导管的置管及护理要点，为临床护理实践提供参考。导管置入及护理要点：置管前根据患者的呼吸状况安置体位，选择半坐卧位或坐位，并在肘部屈曲时选择穿刺部位，包括上臂中段1/3或下段1/3皮肤平整区域；准备加长、加宽的压脉带，并根据血管垂直深度、穿刺角度准备加长穿刺针和导管鞘；置管时使用改良式预置管长度测量法以及超声探头移动引导血管穿刺技术；置管后用弹力绷带8字形环绕固定导管。经过针对性护理，12例极重度肥胖症患者均顺利置入中等长度静脉导管，并经导管完成静脉输液及采血后拔管出院。

关键词: 极重度肥胖症, 中等长度静脉导管, 血管通路装置, 护理